From the Dry Run and National Implementation of the Lessons Learned From the Dry Run and National Implementation of the HCAHPS Survey ~ American Public Health Association Washington, D.C. November 5, 2007

~ Laura A. Giordano, RN, MBA1 Elizabeth Goldstein, PhD2 William G. Lehrman, PhD2 ~ 1Health Services Advisory Group (HSAG) 2Centers for Medicare & Medicaid Services (CMS)

Overview of Presentation Premises of HCAHPS Challenges of HCAHPS Participation in HCAHPS Lessons learned and findings Next steps

1: Premises of HCAHPS Compatibility: HCAHPS must be compatible with patient surveys currently conducted by hospitals 2. Comparability: HCAHPS must produce publicly reported scores that permit fair and valid comparisons among all participating hospitals

2: Challenges of HCAHPS How can valid results be achieved when HCAHPS permits diversity in: Participation by spectrum of hospitals and survey vendors Four modes of survey administration Both stand-alone and integrated formats Two methods of data submission

2: Challenges of HCAHPS, cont’d Solutions: Dry run (practice) the survey Standardization of protocols Training and technical assistance Oversight

Purpose of Dry Run Opportunity for hospitals and survey vendors to gain experience in HCAHPS administration, data collection and data submission Allow CMS to evaluate and refine: Implementation protocols and policy Guidelines for survey administration Data submission and retrieval processes

Standardization of Protocols Survey vendors and self-administering hospitals follow standardized procedures for: Survey modes (four) Generating frame of eligible discharges Survey administration (timing, etc.) Data collection (protocols, etc.) Data submission (XML or On-line tool)

Training and Technical Assistance All participating survey vendors and self-administering hospitals are required to: Attend introductory and update training Apply and receive approval to participate Follow Quality Assurance Guidelines, V2.0 and policy updates posted on www.hcahpsonline.org

Oversight All participating survey vendors and self-administering hospitals required to: Develop & implement Quality Assurance Plans Participate in on-site visits, as scheduled Both random and targeted Successfully submit HCAHPS survey data to warehouse by due dates Data then analyzed for errors, anomalies, outliers

3: Participation in HCAHPS The information presented on slides 11, 12 and 13 is based on the most recent quarter of available data (April - June 2007): Approximately 3,075 hospitals submitted data 97% of hospitals contracted with a survey vendor 3% of hospitals self-administered 88% of hospitals are acute care

3: Participation in HCAHPS, cont’d Approximately 1,495,656 patients surveyed 79% by mail mode 17% by telephone mode 1% by mixed mode 3% by active IVR

3: Participation in HCAHPS, cont’d Age categories of patients surveyed 15% 18-29 years of age 17% 30-44 years of age 20% 45-59 years of age 23% 60-74 years of age 25% 75+ years of age

4: Lessons Learned and Principal Findings Wide range of technical knowledge and resources among survey vendors & self-administering hospitals Rural hospital challenges Zero eligible discharges Roles and responsibilities of hospitals and survey vendors

4: Lessons Learned and Principal Findings, cont’d Sampling Use of appropriate sampling types Nursing home/group home residents Ineligibles/exclusions

4: Lessons Learned and Principal Findings, cont’d Survey administration Lag time Data submission and coding Timely submission of data files Hospitals monitoring vendor data submissions

5: Next Steps Quality Assurance Guidelines, Version 3.0 Conduct Introduction to HCAHPS and HCAHPS Update Training in January 2008 March 2008 Public Reporting Conduct additional on-site visits

Contact Us HCAHPS Information and Technical Support Website: www.hcahpsonline.org E-mail: hcahps@azqio.sdps.org Telephone: 1-888-884-4007

Comments? LGiordano@azqio.sdps.org elizabeth.goldstein@cms.hhs.gov william.lehrman@cms.hhs.gov